W Wayne West OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0PT000682 Issued in GA

Legal business name

W WAYNE WEST OD PC

Practice address

545 Commerce Street
Hawkinsville, GA 31036-1139

Phone

(478) 783-4186

Fax

(478) 783-4185

NPI assigned

Oct 26, 2006

Last updated

Apr 10, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Betty Goodson West

Title

Office Manager

Phone

(478) 783-4186

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1477638849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 446",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310360446",
            "telephone_number": "478-783-4186",
            "fax_number": "478-783-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 COMMERCE STREET",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310361139",
            "telephone_number": "478-783-4186",
            "fax_number": "478-783-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W WAYNE WEST OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "GOODSON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "478-783-4186",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "0PT000682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000004936A4",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "100752",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keyondria Thomas
• Kyle Taylor Thombley, PHARMD
• Kyle Thompson, DPT
• Robert Thornton, CRNA
• Tiffany Wilkerson Tullis
• Walgreen Co (Walgreens #12319)
• Walgreen Co (Rite Aid #3242)
• Haylee Ward, NP-C
• Colleen Wells
• Phillip Kevin Wells, DO

• Optometrist in Hawkinsville, GA
• Providers in Hawkinsville, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.